Archive for the ‘Dieting’ Category

Protecting your arteries

Saturday, June 5th, 2010

I read an article in the "Wall Street Journal" dated June 1, 2010. The subtitle was "How to Turn Back
the Clock when your blood vessels grow old before you do" and that really caught my eye. Most of the article wasn't anything new; you can prevent or lessen damage to your arteries by some combination of eating a healthy diet, controlling your weight, sticking the meds your physician gives you for heart or blood pressure and not smoking.

Okay, so I already knew all that and so should you, whether you actually "walk the walk" or just talk about doing so as so many of us do. Over the years I've quit smoking (when I was a third year medical student and saw a cancer patient smoking through his tracheoestomy), decided, progressively,to lose weight (I'm now under 150 pounds consistently, allowing myself to bounce up and down a few pounds; my max weight, many years ago was 218), eaten a more healthy diet (just got a notice from our local CSA that our weekly "couples veggie share" and "fruit share" will start on the 14th and made sure my blood pressure was controlled

The striking data here appeared in the journal "Circulation" last August, co-authored by a professor of preventive cardiology at Northwestern. Men and women, in his study, who followed the precepts I've mentioned above, could have arteries that were equivalent to those of people 14 to 21 years younger. The flip side was certainly true also. A 35-year-old man who does the exact opposite (smokes, doesn't exercise, has diabetes (probably Type 2 and obesity related) and abnormal cholesterol levels), may have arteries equivalent to those of a 76-year-old.

Your heart, if your resting heart rate is ~70, beats about 100,000 times a day; every time it does so it exposes your arteries to wear and tear. So I had an EKG done last week. My resting heart rate is 53, down from higher levels before I started to exercise regularly. There were no signs of heart damage on the cardiogram and my own personal physician said a while back, "Peter, you've gradually increased your exercise level over the years; now you're doing the equivalent of a stress test every day."

I think I'm on the right track, but I spent time yesterday with a friend whose belly overflowed his belt buckle. I mentioned that I thought he might want to read my blog and he said, "I weighed 174 in high school and I'm only at 185 now."

The problem is where the weight is distributed. Many of us had more muscle mass and less belly fat in high school. We may weigh the same, or nearly so, but still be at considerable risk for heart disease and other blood vessel problems.

I've taken four and a half inches off my waist measurement; is it time for you to do the same?

Another good book

Friday, May 14th, 2010

I recently ordered a book by Susan Yager with the intriguing title The Hundred year Diet: America's Voracious Appetite For Losing Weight. I'm waiting for the book to come in, but the quote in The Wall Street Journal's book review section was enough to hook me. It mentioned a prior WSJ article with a great line from a physician saying, "If there were a drug with the same benefits as exercise, it would instantly be the standard of care."

Yager's book traces our preoccupation with dieting from the early 19th century to the present. Now we're tracking our calories, watching out for high-fructose corn syrup, but prior fads had us on high protein diets, chewing our food and chewing it and chewing it before we finally swallowed the mouthful, avoiding this food or that.

I'm waiting for Yager's relatively slim volume (it's only 260 pages in length), but in a few minutes I'm going to go to the gym and ride a recumbent bike for 65 minutes (or more) until I'm past the 20 miles/650 calorie mark. I'll do some stretches and work on a few machines, but for sure I'm going to ride the bike.

Lynnette in the meantime will be out walking. A recent book by Miriam Nelson and Jennifer Ackerman with the title of "The Strong Woman's Guide to Total Health" suggests brisk walking for an  hour a day. Nelson was the co-chair of the group that authored the 2008 Physical Activity Guidelines for Americans and directs a center at Tufts which concentrates on obesity prevention.

So there's two approaches to losing weight. I don't believe in "fad diets." I do believe in eating less and doing more. Our diet increasingly focuses on more fruits and vegetables and we're looking in to the options with a local CSA (community-sponsored agriculture) organization. We can purchase an "egg share," a vegetable share," a winter vegetable share," and/or a "fruit share."

Here are the concepts that appeal to me strongly: buy local, eat more of the good stuff and find some form of exercise that you're capable of and will do on a regular basis. Carve some time for it out of your busy life. Eat slower. Enjoy your dining companions conversation. Drink some water before that first bite. Serve really small portions of anything you crave that is obviously fattening.

Stay away from fad diets.

So what should I weigh?

Tuesday, April 27th, 2010

I've been reading some of the background material  from one of the articles that appeared in The Wall Street Journal 4-27-2010, in the "Personal Journal" section which today featured Health and Wellness. There were several controversies in other articles: I scanned two: chocolate as a potential antidepressant vs. chocolate being consumed more by those who are depressed; sun-lovers and benefits from sun exposure vs. shade-seekers and harmful effects from excess sun exposure.

The one I was most interested in was titled "A Case for Those Extra 10 Pounds." This one seemed aimed at those who are carrying a little extra in the hips and thighs, rather than the belly. It quoted lots of medical data suggesting there might even be some benefit to a "few extra pounds," an increase in estrogen production  and an accompanying decrease in osteoporosis risk; a Dermatology article was quoted as saying that women who are overweight appear younger than those who are of normal weight or underweight.

So let's go back to basics. One third of all adult Americans are frankly obese, not just a few pounds overweight. They clearly have a higher risk of a number of serious diseases. Many of those in the middle ground between normal weight and obesity, i.e., those who are termed "overweight," carry excess belly fat as well as extra poundage in the thighs and buttocks. I see this all the time in the men's locker room at our gym; my wife says she also notes the same in women. Those folk are also at risk of cardiovascular disease, high blood pressure and, according to some sources, even some types of cancer.

On the other hand, in general, it's not healthy to be underweight People who are underweight may be so because of underlying diseases such as cancer. I should, of course, note that some people who are very slender may be perfectly healthy and are thin because of lifelong exercise (long distance runners come to mind).

We all tend to look for excuses and to rationalize our issues away. So if you're lean around the midsection and carry a little extra elsewhere, perhaps you are okay. But I'd suggest you should take a good hard look at your waistline before concluding that you're one of the folk who can safely carry some excess pounds or not.

Blog ahead in Spring...

Sunday, April 18th, 2010

We'll be heading down to Colorado Springs on Thursday for the Pikes Peak Writers Conference (and my 69th birthday dinner with cousins). So instead of writing blog posts on Tuesday and Friday, as I normally do, this week I decided to "blog ahead."

Two articles in our local paper got my attention recently. One I'll pair with an article and also with an accompanying editorial comment from the Annals of Internal Medicine, but that can wait till Wednesday as I've not yet fully digested (no pun intended) the dietary advice from the three sources.

Today I wanted to mention a local initiative from the Food Bank for Larimer County, one of our favorite non-profits. I've worked volunteer shifts there when I belonged to a Rotary Club and my wife and I always give the Food Bank one of our larger yearly donations when we start figuring out what we can manage to give to charities.

The organization's director, Amy Pezzani, said in the paper that the Food Bank had 32,000 more visits in 2009 than in 2008. One fifth of our kids in the county are receiving food through schools, food stamps or the Food bank itself.

Yet data collected by other groups says that in that same time period, more than half of our Larimer County residents fall into the overweight and obese groups and one fourth of our students in the K-12 category (I didn't see any statistics for Colorado State University students).

Now the Food Bank has combined their need for more food with our region's excess weight issue. A national TV show gave the local folk the idea of a "Pound for Pound Challenge and Pezzani and her crew have gotten over 700 local residents to pledge to lose nearly 20 pounds each by July. So far, they were up to a 13,000-pound pledge and they're aiming at 50,000 pounds.

Each participant joins the challenge by registering online with a local ZIP code and gives the Food Bank a small donation equivalent to the number of pounds they plan to lose. Pezzani said the 50,000 pound goal would be the the equivalent of two truckloads of food. At the time the article was written, Colorado was ranked 12th in the country in the contest with 135,000 pounds being pledged and Larimer County was third in the state.

Talk about a win-win situation. This idea should be publicized even more widely than it already has. Spread the word.

Pushing the edge: a hodgepodge

Friday, April 16th, 2010

I wrote recently about Springfield's horseshoe sandwiches using them as one example of things in our society's food frenzy that I don't want to join in. Since then I've run into a number of other examples and, fortunately, some opposition to these. I'm going to quickly describe a few of the trends I view as potentially dangerous for those of us who want to stay slim (or become slender) and remain healthy.

One article described how high-end restaurants are experiencing a boom, in some case having up to 30% more business. I read that with perhaps a touch of envy, but decided that the trend for fancy dining came from abundant crops and cheaper prices for strawberries, wild mushrooms,and some varieties of carrots.  Those things I can buy for myself in the farmer's market or the supermarket

My greater concern came from reading two articles on foods being offered for sale that offer much greater risks than fancy restaurant meals. One was on bushmeats, illegally-imported flesh that comes from bats, monkeys and rodents...considered by some to be delicacies and apparently smuggled into the NYC area. Now you may not live near the New York City so this may appear to be of distant interest, but those strange meats have been found to contain a strain of a virus that is distantly related to HIV and many scientists think that consuming such products is how humans first came to be infected with HIV.

Then there's the unpasteurized milk debate. Public health officials (my Dad was one of those), are absolutely against drinking "raw milk," though its advocates claim it has many health benefits lost when the milk is pasteurized, defined as being heated enough to kill harmful bacteria.  In March the FDA reported twelve cases of sickness in the Midwest that apparently were tied to a dairy selling "raw milk." The agency is reviewing its policy on hard cheeses made from raw milk. At present you can purchase those if they are aged sixty days or more. Fresh cheeses made from raw milk have also been linked to disease out breaks.

So you make your choices and decide for yourself. There's a range of food available from the exotic to the expensive to the somewhat mundane. Just remember, to start with, that prior to 1938, when pasteurization became the norm, cow's milk was responsible for a quarter of all water- and food-borne illness. And bushmeat may have led to our current HIV epidemic. As for fancy restaurants, I'll save them for special occasions.

Subtle messages

Wednesday, April 7th, 2010

I was leafing through The Wall Street Journal this morning, quickly, as I got up late, will read a book for my men's book club most of the morning and then go to Loveland, eight miles south, to lunch at a restaurant I've never eaten at before. I'm going there to meet a writer friend whose book I've been proofreading.  I saw the headlines in the front section of the paper and will return to them later, but was struck by an article in the last section, the one called "Personal Journal."

The article's title was "What Your TV is Telling You to Do." That caught my attention so I read the whole thing. It's about NBC's use of the technique of "behavior placement." Instead of trying to sell you a specific product by having the star of a show drink, eat or use it, this idea is to show you a kind of behavior you may then decide, consciously or unconsciously, to emulate.

The thing that's different here is that some NBC's shows are now sending you messages, or rather signals, to recycle, exercise and eat right. Presumably they're not just doing this because it's the right thing, but, in part in least, because it will help them sell ads. TV has enormous power to get huge numbers of viewers to do something, because their favorite character does it.

In this case the stars of various shows will be exercising or eating healthy food choices. I'm going to wait and see what the outcome is and maintain a goodly amount of skepticism, but the overall concept is one I love.

For years we've been sold, via ads (which I mute and many who use Tivo skip), products that by no stretch of the imagination could be termed healthy choices. Now, finally, someone is going to try to influence us to make better choices. I'm all for it.

Weight-loss fundraiser

Friday, March 12th, 2010

Fascinating article and accompanying editorial in our local paper today. It seems that General Mills and other big businesses have pledged $0.14 to food banks across the country for every pound lost by their area residents. What a double win that could be: here the Food Bank for Larimer County has noted a huge increase in the number of visits by those in need of food help; up 32,000 from 2008 to 2009. Twenty percent of the kids in the county get food assistance either through the schools or food stamps.

At the same time, although Colorado is a "relatively lean" state, more than half of the people who live in my county fall into the overweight and obese categories (that includes one fourth of the students in our school district). We face a quandary in these difficult financial time; it's cheaper to buy unhealthy food choices than healthy ones.

So our Food Bank has over 13,000 area folk who've pledged 13,000 pounds so far and is aiming at 50,000 pounds in pledges. If they succeed, they'll get $7,000 from the corporate sponsors of the "pound for Pound Challenge," be able to feed more of our our-income residents and, at the same time, help those who pledge to become healthier.

It's hard to think of a better "twofer" than that. Wherever you live, I'd suggest seeing if your area food bank is participating. Join in on this wonderful plan to help others and yourself.

Can I still eat Dairy Products?

Friday, February 26th, 2010

My wife and I both take calcium supplements, in my case two tablets of calcium citrate with vitamin D in the morning and two sometime later in the day. (Lynnette takes two and then three).  Each has 630 milligrams of calcium and 500 IU of vitamin D.  I haven't had a bone density test; hers was slightly on the low side originally and has improved more recently. We're both small-boned and in our late sixties, so the supplements make sense.

How about dairy products? Well Lynnette has no problem with drinking milk and usually has a small glass of it daily + pours some on her cereal.  I'm lactose-intolerant, i.e, lactase deficient, so I use soy milk on my cereal and often eat a bowl of cereal at two of my three meals, especially if I'm on my diet. Today, I weighed 148.4 pounds, so I'm at or even slightly below my goal weight, and can eat a bigger lunch if I want to (we're invited out for a bison dinner, so I may not).

There was an interesting article on lactose-intolerance in The Wall Street Journal recently (Health & Wellness Thursday, February 16, 2010, page D3. Dr. Eric Sibley, a Professor at the Stanford School of Medicine, is quoted as saying while most people lose the ability to produce lactase in large quantities as they grow up, a majority still secrete some lactase.

For those who still can produce lactase, stopping diary ingestion entirely is counter- productive. Our gut bacteria can be trained, apparently, to tolerate more dairy if exposed to it on a regular basis. On the other hand, if you stop consuming all dairy products when you first diagnose yourself as lactose-intolerant, your bowel bacteria get less efficient in their lactose handling.

Some dairy products, cheese and ice cream among them, have been processed and, as a result, tend to contain less lactose. Other foods have lactose added to them (some cookies in particular).

Dr. Sibley said most of us who are lactose-intolerant can drink one or two glasses of milk a day without symptoms. We all need calcium, so it makes sense to have some cheese and milk regularly and perhaps even a little ice cream as a special treat occasionally.

A few people have a true allergy to milk that's not caused by lactose; instead of gas and bloating, they develop abdominal pain and may have bloody stools after drinking milk. Those folk can't safely follow Dr. Sibley's advice for the rest of us. As for me, I may attempt to retrain my gut bacteria to do their best with lactose-containing products; I'll go have a small glass of milk right now.

Wall Street Journal: The teaser vs. actual article

Tuesday, February 23rd, 2010

I picked up our copy of The Wall Street Journal from the driveway this morning, and was startled to see a front-page teaser "Why Evolution is Making Us Fatter." I immediately turned to the Personal Journal section which had A Health and Wellness theme today and read the article which actually was titled "Obesity? Big Feet? Blame Darwin" with a subtitle "Evolution Helped Humans Have Children and Survive, but It Also Led to Modern-day Maladies, Scientists Say."

Many modern scientists think we're a collection of compromises arising from our predecessors' adaptation to changing environments. The obesity related sections were certainly there, but they were a minority among paragraphs on the evolution of lactose tolerance, skin color, immunity and brain size, among other topics. But I wanted to concentrate on the weight-related arena. The first such mentioned the move from hunter-gatherer status to agriculturalists roughly 10,000 years ago and the subsequent dietary shift to more carbohydrates leading to a decrease in average population height and more obesity. Most populations have adapted over the centuries to the new foods; those that made this change more recently were said to have higher rates of obesity and diabetes type 2.

Then there is the hormone leptin, our body's signal to stop eating. I found British Medical Journal articles dated 1996 on its discovery and chemistry, but the initial promise that it could be used to help the obese lose weight was stymied by the finding that obese humans usually develop leptin resistance. I also found a current website from a clinical nutritionist advertising the "leptin diet," a set of five eating rules that mostly made common sense. The first three: never eat after dinner; eat three meals a day and don't snack; don't eat big meals are all concepts that I'd agree with: the other two: eat a high-protein breakfast and decrease the amount of carbs eaten, I'd modify. I've moved away from eating white bread, white rice and white potatoes in excess, but complex carbohydrates are certainly still on my list of good foods to eat. And I have decreased my overall intake of red meat as a source of protein, so no more breakfast steaks.

Overall leptin seems to play an important role in our bodies. There was a 2009 article on the website www.medicalnewstoday.com which reported that there were several FDA-approved oral drugs that can sensitize the brain to leptin. Investigators at Boston's Children's Hospital were working toward  clinical trials.

I need to see more research before to be convinced that leptin levels markedly decrease when you diet and therefore you burn less of ingested calories and regain weight.  And, for now, I'm not at all interested in the websites which offered "pro-biotic and herbal cleansing" products to overcome leptin resistance.

An interesting article

Tuesday, February 16th, 2010

The Wall Street Journal had three health-related articles today 2-15-2010). Since I'm lactose-intolerant I read one on that subject first and may blog about it in the future. One had nothing to do with diets, but dealt instead with winter asthma. The third article was titled "Why Some Foods Are Riskier Today." That one really got my full attention. It talked about food-borne illnesses which affect 76 million people a year in America (and that's only the ones that get reported). Most are not severe, but nearly a third of a million lead to hospitalization and 5,000 of those affected die.

Well some of the apparent recent increase in these food-related cases may be due to better detection and reporting; lots are due to three major causes: new "bugs" that can lead to sickness;  consumers desire for raw foods which have not been treated to remove bacteria and food imported from areas of the world whose food-safety regulations aren't as stringent.

Many of us want to have the wide variety of food items year round that we can buy from local sources only in season. This may increase our menu choices, but also can lead to consumption of dangerously tainted vegetables and other foods. Over the past three years my wife and I have become more and more "locovores," people who basically eat things produced in our area. That does limit when we can have mangoes or rambutans or other fruits and vegetables, but it also supports local agriculture and, at the same time, makes our diets safer.

I've also given up on my formerly nearly rare hamburgers and purchased grass-finished (non-feedlot) bison, lamb and beef from local and regional growers. Our dairy products come from a farm about eight miles northwest of us.

I see this as a trend in our area. There are more farmer's markets, more opportunities to purchase locally grown/raised foods, more awareness of the risks of our mass-production food industry.

They may cost a bit more, but frequently the taste is better and clearly the risk is lower. it's worth the small amount more that I pay. An often added benefit is being able to buy heirloom tomatoes and other fruits and vegetables that we don't usually see in the supermarket.  To whatever extent is possible for you, I'd suggest becoming a locovore; it's a habit you'll find healthy and tasty.